Symptoms

There may be no symptoms. The condition usually causes chest pain behind the breastbone, which may spread to the neck or arms. The pain may be worse when you take a breath or swallow.

Exams and Tests

During a physical examination, the doctor may feel small bubbles of air under the skin of the chest, arms, or neck. A chest x-ray or CT scan of the chest may be done. This is to confirm that air is in the mediastinum, and to help diagnose a hole in the trachea or esophagus.

Treatment

Often, no treatment is needed because the body will gradually absorb the air. Breathing high concentrations of oxygen may speed this process.

The doctor may put in a chest tube if you also have a collapsed lung (pneumothorax). You may also need treatment for the cause of the problem. A hole in the trachea or esophagus needs to be repaired with surgery.

Outlook (Prognosis)

The outlook depends on the disease or events that caused the pneumomediastinum.

Possible Complications

The air may build up and enter the space around the lungs (pleural space), causing the lung to collapse.

In rare cases, air may enter the area between the heart and the thin sac that surrounds the heart. This condition is called a pneumopericardium.

In other rare cases, so much air builds up in the middle of the chest that it pushes on the heart and the great blood vessels, so they cannot work properly.

All of these complications require urgent attention because they can be life threatening.

When to Contact a Medical Professional

Go to the emergency room or call the local emergency number (such as 911) if you have severe chest pain or difficulty breathing.

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